1Columbia University, College of Physicians and Surgeons, New York, United States, 2New York State Psychiatric Institute, Washington Heights Community Service, New York, United States, 3Teachers College, Columbia University, New York, United States

Background: The need for HIV/AIDS services in mental health
settings has been documented in many countries, but coordinated delivery of
these services is rare. This study examined the effect of HIV training on HIV
service integration in agencies providing mental health services. We expected
that if workers in these settings were given training that provided
information, enhanced their motivation, and improved their skills (the Information, Motivation, Behavior Skills--IMB--Model), HIV/AIDS and mental health service
integration would increase.Methods: Of 176 agencies seeking HIV training throughout
NYS between August 2007 and October 2011, 98 agencies providing mental health
services (55.7%) completed a needs assessment survey. Path models are fitted to
illustrate the effect of HIV training (shown
in Figure 1) on HIV service integration (e.g. HIV- risk assessment, -test
counseling, -risk reduction intervention)
in mental health settings. The direct effect and the
indirect effect via staff´s HIV expertise (shown in Figure 2) as a moderator are specified. Since the outcomes are not normally
distributed, models for categorical responses are fitted with the log odds
ratios to examine the
relationships among variables.Results: We found significant effects of HIV training on HIV service
integration moderated by staff's HIV expertise. The direct effects of HIV
training on HIV service integration are not
significant after controlling for staff's
HIV expertise, while indirect and total effects of HIV training on HIV
service integration were significant. Moreover, agencies with more frequent
trainings showed stronger effects of training on HIV service integration (see
Figure 3).Conclusions: Providers in mental health care treatment
settings receiving more HIV mental health training have a higher HIV expertise level
and are more likely to integrate HIV services into their practice than others. These
results support the IMB model and demonstrate the importance of HIV mental
health training in enhancing comprehensive care among mental health providers.